CAJ | 학술논문

目的：观察疏肝健脾方联合胡椒敷脐治疗腹泻型肠易激综合征(irritable bowel syndrome with diarrhea，IBS-D)伴精神心理障碍的临床疗效。方法收集2011年1月至2013年1月年广州市南沙中心医院就诊的IBS-D伴精神心理障碍患者64例，按随机数字表法随机分为2组，治疗组33例，予疏肝健脾法方药口服配合胡椒敷脐治疗；对照组31例，予匹维溴铵和氟哌噻吨美利曲辛治疗，疗程4周。观察疗效，对比治疗前后抑郁积分（HAMD）、焦虑积分（HAMA）、生活质量积分（IBS-QOL）和症状严重程度积分（IBS-SSS）。结果治疗后，治疗组和对照组HAMD积分、HAMA积分、IBS-SSS积分较同组治疗前下降（治疗组t值分别为14.280、13.530、18.847，对照组t值分别为11.514、9.424、13.829， P＜0.01），IBS-QOL积分较同组治疗前升高（t分别为-16.848、-11.712，P＜0.01）。治疗后治疗组HAMA积分、IBS-SSS积分、IBS-QOL积分改善优于对照组（t分别为-3.183、-2.549、3.904，P＜0.01或0.05）。治疗组总有效率为94%（31/33）、对照组为75%（23/31），两组总有效率比较，差异有统计学意义（χ2＝4.727， P＜0.05）。结论疏肝健脾方配合胡椒敷脐可有效改善IBS-D伴精神心理障碍患者的临床症状、抑郁焦虑状态，提高生活质量。
목적：관찰소간건비방연합호초부제치료복사형장역격종합정(irritable bowel syndrome with diarrhea，IBS-D)반정신심리장애적림상료효。방법수집2011년1월지2013년1월년엄주시남사중심의원취진적IBS-D반정신심리장애환자64례，안수궤수자표법수궤분위2조，치료조33례，여소간건비법방약구복배합호초부제치료；대조조31례，여필유추안화불고새둔미리곡신치료，료정4주。관찰료효，대비치료전후억욱적분（HAMD）、초필적분（HAMA）、생활질량적분（IBS-QOL）화증상엄중정도적분（IBS-SSS）。결과치료후，치료조화대조조HAMD적분、HAMA적분、IBS-SSS적분교동조치료전하강（치료조t치분별위14.280、13.530、18.847，대조조t치분별위11.514、9.424、13.829， P＜0.01），IBS-QOL적분교동조치료전승고（t분별위-16.848、-11.712，P＜0.01）。치료후치료조HAMA적분、IBS-SSS적분、IBS-QOL적분개선우우대조조（t분별위-3.183、-2.549、3.904，P＜0.01혹0.05）。치료조총유효솔위94%（31/33）、대조조위75%（23/31），량조총유효솔비교，차이유통계학의의（χ2＝4.727， P＜0.05）。결론소간건비방배합호초부제가유효개선IBS-D반정신심리장애환자적림상증상、억욱초필상태，제고생활질량。
Objective To observe the traditional Chinese medicine (TCM) and umbilical treatment on diarrhea-predominant irritable bowel syndrome(IBS-D)with mental disorders. Methods Thirty-seven cases with IBS-D were randomized into a treatment group(33 cases) and a control group(31 cases). The treatment group was given Shugan-Jianpi TCM decoction and pepper umbilical dressing. The control group was given Pinaverium Bromide Tablets and Flupentixol and Melitracen tablets. After having been treated for 4 weeks, Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD), IBS Symptom Severity Scale(IBS-SSS), IBS quality of life questionnaire (IBS-QOL) were determined. Results After the treatment, HAMD, HAMA, IBS-SSS in the treatment group and the control group all significantly decreased (the treatment group t=14.280, 13.530, 18.847,the control group t=11.514, 9.424, 13.829, P<0.01), and IBS-QOL increased markedly(t=-16.848, -11.712, P<0.01). Compared with HAMA, IBS-SSS and IBS-QOL in treatment group, the control group showed statistical difference(t=-3.183, -2.549, 3.904, P<0.01 or 0.05). The total effective rate of the treatment group was 94%higher than 75%of the control group(χ2=4.727, P<0.05). Conclusion Shugan-Jianpi TCM decoction and pepper umbilical dressing can improve the clinical symptoms and psychological symptoms and improve the quality of life of IBS-D patients.